Renal involvement in prolonged salmonella bacteremia: the role of schistosomal glomerulopathy

Revista do Instituto de Medicina Tropical de São Paulo

Reinaldo Martinelli²  Luis Jose Cardoso Pereira²  Edilson Brito¹  Heonir Rocha² 

[1] ,Universidade Federal da Bahia Faculdade de Medicina Departamento de MedicinaSalvador Bahia ,Brasil

关键词: Schistosomiasis mansoni;    Prolonged salmonella bacteremia;    Glomerulonephritis;    Clinical manifestations;    Histopathology;   

DOI  :  10.1590/S0036-46651992000300002

来源: SciELO

【 摘 要 】

Renal involvement has been well documented in patients with hepatosplenic schistosomiasis and in patients with prolonged salmonella bacteremia (PSB). Whether there is a specific renal lesion related to PSB or the chronic bacterial infection aggravates a pre-existing schistosomal glomerulopathy has been a matter of controversy. To analyze the clinical manifestations and histopathological findings of the renal involvement, 8 patients with hepatosplenic schistosomiasis and PSB (group I) were compared with 8 patients with schistosomal glomerulopathy (group II) matched by sex and glomerular disease. The mean age in group I was 17.7 years. All patients presented with hematuria, in 4 cases associated with non-nephrotic proteinuria. In group II the mean age was 23 years; nephrotic syndrome was the clinical presentation in 7 of the 8 patients in the group. All patients in group I experienced remission of the clinical and laboratory abnormalities as the salmonella infection was cured; in group II the patients had persistent, steroid-resistant, nephrotic syndrome. On histological examination, no difference was noted between the two groups, except for pronounced glomerular hypercellularity and interstitial mononuclear cell infiltration in group I. These observations strongly suggest that PSB exacerbates a pre-existing sub-clinical schistosomal glomerulopathy by the addition of active lesions directly related to the prolonged bacteremia

【 授权许可】

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